Excretion (stool passing) in children

Your child’s faces contain the indigestible parts of the food that your child eats, such as fibre, as well as the waste products of normal bodily processes and any toxic substance that the body wishes to remove. Bile pigments (Bile is a digestive fluid that is made and released change nappyby the liver and stored in the gallbladder) lend the stool its colour, nitrogen compounds which are produced by the action of bacteria give its characteristic odour. From the bowel, faecal matter is passed to the rectum, where it is stored. Once the rectum is full, pressure from within produces the urge to open the bowels. The stool passes out through out your child’s anus which, like the bladder, is kept closed by a ring of muscle, is called the anal sphincter. It is the action of relaxing and contracting the sphincter, and of pushing by exerting pressure within the abdomen, that forces the stool out of the body. As with the bladder, this happens automatically until your bladder has developed sufficiently to gain voluntary control of these muscles.

How much and how often stool should be passed by the child?

There is no such thing as a normal number of stools or a correct number of times your child should pass them. What is the normal number for one child may be completely different for another? Some newborn babies have bowel movements each time they feed because the action of sucking and swallowing sets off the reflex that opens the anal sphincter. Others, usually those who are being breastfed – fed, may be well and content going for several days without passing a stool. The reason for this is thought to be that your breast milk is perfectly matched to your baby’s need that there is hardly any waste material to pass out as stools. If our baby is fed formula milk baby is likely to pass stools fairly regularly, usually around once or twice a day. However, as with breast – fed babies, more or less than this is also perfectly normal, as long as the stools, when they do come, are soft and easy to pass.

For toddlers: A toddler, eating a normal diet, may pass stools once or twice a day, others may need to go every day. This is normal as per the stool becomes hard to pass. Some children have a natural tenancy towards constipation and can be affected, not only diet or lack of fluid but also upsets or changes in routine. Consult your Doctor or GP, if they will prescribe you some laxatives or suppositories then you can give it otherwise do not give.

Color and consistency: Your baby’s first stools will be a blackish- green color as the meconium (it is the earliest stools of a mammalian infant form, it, is composed of materials ingested during the time the infant spends in the uterus)  from the amniotic fluid work is  its way out of baby’s system. Once feeding is established, her stools will become loose and yellow if she is breast fed and brown colour and firm stool If she is having formula milk. Changing form one formula to another type may lead to runny stools for few days until your baby is used to new feed. If these runny stools last for more than four days you should ask your Doctor or GP. Breast fed babies are unlikely to have diarrhoea, but if it occurs with vomiting or fever or blood in the stools, you should consult your Doctor immediately.

During Weaning: Once you start weaning your baby, you may notice that the colour and consistency of her stools change again. Introducing new solid foods with particular colour like beet root, blackcurrant into the diet can produced dark black or brown or red colour of stool but it is quite normal.

Tip: If your baby is breast fed and you are taking iron tablets or liquid daily it may also change the stool colour, especially dark black colour. It is normal.

Constipation: This is when a child has dry, hard stools that are difficult to pass. Infrequent bowel movements are not necessary a sign of constipation, some breast fed babies go several days between stools, but as long as the stools are soft and easy to pass this is nothing to worry about it. It is not a disease but it is the problem related to your child’s digestion system, that means it is difficult and painful to your child to pass the stool. There may be a little water in the stools, making them dry and difficult to pass – dehydration is a very common cause of constipation. While bottle fed babies also suffer from the same problem if the mixture of feed is at improper concentration. Other factors like upset stomach or physically hold their stools. In weaning babies due to start new solid foods cause constipation.

Treatment: babies may be helped by increasing their fluid intake. Older children can benefit from extra fibre in their diet so include plenty of fruit, vegetables and cereals. If you suspect a particular food is responsible for your child constipation, try eliminating it from his diet for a few days and then offer it again to check constipation. Try to give more fibrous food because fibre holds water, making the stools softer, and adds bulk, making them easier to pass.

If constipation becomes the long problem then consult your Doctor or GP. They may suggest you laxative which will soften the stool and easy to pass.

Fibrous food: List includes fibre amount in gm per 100 gm product.

Source in 100 gm Fiber in gm
Wholemeal flour 10
Wholemeal bread 6
White bread 2
Brown rice 2
White rice 1
Cornflakes 2
Apples 4
Bananas 2
Avocados 6
Carrots 4
Spinach 3
Cabbage 3
Sweet corn 2
Potatoes 2
Lima beans 7
Baked beans (canned) 6
Peas 7
Apricots 8
Prunes 7
Dates 8
Resins 4
Almonds 10
Peach 3

Spastic Constipation: This type of constipation is caused by the large intestine going into spasm and holding onto small pieces of the faces until they become dried into little balls. The stools eventually appear as a collection of small, hard balls that are difficult to pass. Mostly this is caused by formula milk fed children or in new weaning period diet. Because the quantity of formula may change and in weaning new food introduce, in both condition digestion is difficult.

Anal fissure: Constipation makes the stools hard, and passing them may cause a small tear, known as an anal fissure, in this delicate mucous membrane of your child’s anus. This makes it painful for your child to pass a stool and can lead to a small amount of bleeding from her anus. Although on first sight this is worrying, the bleeding is not usually serious – it is just like any bleeding from a small cut. There is a risk that a child with an anal fissure may try to avoid passing stools because of the pain, which can compound the problem by making the stools harder and even more difficult to pass.

Treatment: Drinking plenty of water or fluids will keep stools soft and easy to pass. As the area is always moist, healing can take time.